Altered Mental Status

Altered mental status is possibly the most common presenting complaint for patients in the emergency room, especially gomers. Delirium, confusion, agitated, sleepy, lethargic, doesn't matter... It all falls under the umbrella term of altered mental status.

Epidemiology

Nearly 100% of patients over than the age of 65 have experienced altered mental status in any of its glorious forms. In fact, the risk of altered mental status increases with age, length of stay, number of comorbidities, number of medications, and number of alien bodies introduced (central line, arterial line, Foley catheter, etc.).

Causes

Ha! What doesn't cause altered mental status? What we will say is that in the 1940s, electroencephalograms (EEGs) helped document that altered mental status was the result of global cortical dysfunction. What it did not capture was seizures, because EEGs never capture seizures. In sum, when you have a patient with altered mental status, just document "multifactorial" as the cause and you'll be all set.

As for the health care professional population, the most common causes of altered mental status are hanger pains, uremia from not urinating all month, and cirrhosis from too many liver rounds.[1][2][3]

Symptoms and Signs

You name it: disturbance in attention, fluctuating attention, memory deficit, disorientation, agitation, confusion, throwing poop, ripping out PICCs and Foleys, and making known to all their impressive vocabulary of curse words.[4][5]Sundowning is a subtype of altered mental status where gomers and gomeres go batsh*t crazy the second the sun sets.